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Descemet membrane endothelial keratoplasty for graft failure following penetrating keratoplasty

  • Cornea
  • Published:
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Abstract

Purpose

Descemet membrane endothelial keratoplasty (DMEK) is superior to penetrating keratoplasty (PK) in terms of visual rehabilitation, intraoperative safety and risk of rejection. Therefore, it seems reasonable to perform DMEK in eyes with endothelial failure following PK. We herein report our first clinical results.

Methods

Nineteen eyes with endothelial graft failure following PK were treated with DMEK. The majority of these eyes (12) had limited visual potential. The major indication for DMEK was pain relief in patients with bullous keratopathy. Visual acuity (VA), central corneal thickness (CCT), rate of graft dislocations, graft survival, graft rejections and other complications were extracted from the medical records.

Results

Although comorbidities limiting VA were present in 12 of the 19 eyes, VA increased from 0.05 to 0.1 (median) in 16 eyes. CCT decreased substantially (range 63–363 μm). Rebubbling was necessary in five eyes with incomplete graft adherence. There were two immunologic graft reactions and three graft failures. No major complications like endophthalmitis or expulsive bleeding occurred.

Conclusions

DMEK is feasible to treat endothelial graft failure following PK. This is even true for eyes with limited visual potential.

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Authors and Affiliations

  1. Eye Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Killianstr. 5, D-79106, Freiburg im Breisgau, Germany

    Sonja Heinzelmann, Daniel Böhringer, Philipp Eberwein, Thabo Lapp, Thomas Reinhard & Philip Maier

Authors
  1. Sonja Heinzelmann
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  2. Daniel Böhringer
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  3. Philipp Eberwein
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  4. Thabo Lapp
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  5. Thomas Reinhard
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  6. Philip Maier
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Corresponding author

Correspondence to Sonja Heinzelmann.

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No funding was received for this research.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ethical board Freiburg, AZ 88/12) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Heinzelmann, S., Böhringer, D., Eberwein, P. et al. Descemet membrane endothelial keratoplasty for graft failure following penetrating keratoplasty. Graefes Arch Clin Exp Ophthalmol 255, 979–985 (2017). https://doi.org/10.1007/s00417-017-3600-6

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  • DOI: https://doi.org/10.1007/s00417-017-3600-6

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